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/r G .Y 1116 r rw a 7 y 'TOWN OF NORTH ANDOVER This certifies ............... buildingsss on f.,gas installation in the of a ..r..,..� ...�v.......„.................................... ........... .�..' ... North Andoverg ass. r•..M w....e.an w.... c. /^. i m GAS Chec I' .... .". , i MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO,PERFORM GAS FITTING WORK e�'mm'wf,,,�YAxwolXry ,bns,Fr,MMAmrMVHn .nv�-r-.,.�r"•i�telF - „Y �.. x q�.. CITE „ .g .w.,. r DATEPERMIT 0 1 �� ^'� �Ps'r14dT� 6uI�A�WiWW:IG` 'm'x'�'""_. -•'e�..n r-wa,mm.11 x u✓w ww� ew �-„ .. :.rnl�e,�,. '� iXRXYNii1H1IM.YmYAM¢hwHHHrvlrvM�++d �� 'n', , ITS � �� � y � n j 0 � � tR��il¢YM� MTY ."H'uHXaaliYlml®iliMW�.1lAm. 'PRW�'.,¢ . G Y „ V� � WmHup'u¢¢HYWwm.�IwldMwiwYHlf'YH.w'wYi'H.WMwwrt, OWNER /kX Es S T L F ��ga_,�.. m . ,•gxry mm rni.--.- a .++w. e•w.tienivrw v�, .n,n.. .g. ..mm IPI+we^!rvel'i'""4"Y"'^I:l,'" re+te---+�b+.*�rw.n,..wenw.�ww.r en� wn«mmnn�xrra��.ri.a.ary W�.a.a� f f T'YPE OR, A r 9iAF-rr�a'Yr.YrrT',• �us6hr. .u�.��iarri rxn„�am'.�T. I IY�i�M'. I �I IT1LGC G 'TYPE C M RCJ L EDUCATIONAL120, PRINT CLEARLY ° REPLACEMENT: E-1j, LADS SUB ITT , YESMF TI � E—J] APPLIANCES FLOORS-4 SM 1 ',,.�.-"^.�"-c�x-_5;"._^_'-�m w.�."r+.:.^.=,"�..y_w'�-g._i'-ra',S�,r"..""'_.,..,..�.�,�n+w.',^"":i+'r.�-'¢w�__.r_w.��....vr^LH wYwexw.g,s..."ma s g:TW"-_C'ry�l:a+av.�._I•v"n,PQ 7.';,;�.,u:„_..__y.r_!,.-....�a, 1w.w.w�Yrv.�rv,w.iw�mx 10 a� I 1 BOILER .. m^g1 BOOSTER [:A[ *,- .CONVERSION BURNER OK, wawu , STOVE p�pll 7777, 177 ,�,. 1 , E DIRECT'VENT HEATERI M.w .. . DRYER ,� . ;._ . 1...YrH.an,✓.,irr,. , ��r ,r^ FIREPLACE �C., .. Y']__"i C"l,_mm�ara.nn T�.:,.r.ul.:m�.�.�✓�`emn ��..a..^�-;.,.ram-�-" '-'^.R,4:.L „Y. x�nm wr. _�J ,....-,�r„�m�+,-„ '+, .mr�.re..m�..... ..ra�.n��.,r�mn,a�xm..nmrmm. �✓.,._.,.,x..,,.n��m.�a� „,.:�,..m�---,.�.-rr n �«ww:,:i.` �nm„a.marr..,aar�.. rm a�J¢.._,.r�rv�nrrr�. „,,,"✓",�-°�";,I -,r.:w,..n✓.w.,.a.. x_,...a._ a.-w.._._"'�^�, .���y'�" - mm,Y.,.,,. �.� we.�mm ..�. __ �w._e�.._w_"w.aaa �✓-�� .��xmmw�a.e�a � u¢ .�I as =,�_, �... . �-.-�___ .-__ � �� .a ��.. ._ , � �.� ✓�.me.�.w�. .�� �.�w...e�� a.a,_.a._��__ �� _. FRYOLATOR FURNACE .... �...,... .� .�,; r~. ,...,..,. ,,, m,.m A,�xc�-tl �,r.�...ar,_a_,_...,..✓____,.�r�..,. ,�,„-.^. >p✓a, .,�,.a...mm xa,.�.°....,..wn, _._��,...,�....,e._.Wa.�--�.H.°,.�.00LL,,..�..mm,�..r-.,. GENERATOR, 17-1 GRILLE INFRARED - a HEATER I Yip m_ I a.a �.�.dYm�,.�;.. -. ,. _,_ �. �.. ..�r..7 w�n�®.�_.,. i"r s �._. r."_...u_ :�^®_�^„��. ,,:,r�:"'e- ,�_^: _.`,ca"'r-,��_� __ -!-✓_�a.-'.-_, L "'..^_^^��_.__�-���.__�:_„_��_.�ar:_ 4, :._; ,I k`,__. ..::�_°."'-W'.✓ �,..,. ,,,'T-r--TM'*Pr-,. „-�--.-,-,..m r�x�.„�F� -,�� ✓�'ra�., '��� «W �-� ; '� YI v4�yq'�f � MAKEUP AIR UNIT OVEN r I Ll POOL,HEATER ROOD, SPACE HEATER - „...m ,,."kw�.✓.,�' �-�a.z,_,.. „,tea_.. �� ='=,�"tp�e,,,-' mm�„,m'-- ,.a�.,..�M A � ... ..� a °-°,t.°"...,, ROOF ___,•". .r _,. �,,,-ram ,,.�w � °.' m^_a^,�°^_�; wmrw ..✓�grpn �� °�O ' ITF,7,- TEST9 I . ors -__._cam.^ _,^rw .,n ,�,. ,,.. �✓✓. m..�.w✓ L��j , i. �'w"-",�; ✓.��,xn�..r "`.--_".-,*.w-`*�.,""_., 'h`,TM"-rAw. n^.r�r-.rr .'a,2.. „�.r_._. ..,.. �.T„ I [7UNIT HEATER WATER HEAT , x :.,,..�g�., .�r�Y�i�,r;,, i.,Y�Y,,�.,r._,.Y,r. �✓,rve.a»W,« a„� - ,.._E.,.�I�k-.. - m .�r� _ I _ mma w r mm mm, _ I .................. w ._r"��nr ,-✓ri�a�' °*mr,^r��mr...,F.~h-"�rmq,.f ,F..i l+rw�. ..«rv:.. ., --,x<m.�Y ,. .... , v.r.,, ,:_ar„4 _..___..;,_;_ .._�,,.,___,® .._,�..,.�;"^,n_:n,,,�: , ,.ae.'�'G""o'"_"7. � �Y._111=:�� '""arr. p-.-,a-�ry"'w,..,,�rw"u�'' -,.,-..-..!L,.,"-.,.i�.n,,.,rw,�.,m, ,e��vY✓L" .^-- +"4,Jm:MA."" rwll-.aw,«.�,Y..®� ...,.... - .Y.....,m.iYr..:.�.�,.rr w,.rM x.,¢~' 'I " :IN, o�.a__,�„re-m. ,,r✓•man..,.xwmavxva,; u_ua� w+w'. emn n.._ x �'�.war�.wrrWi w ---n��-r-m-.myn...rr.W�.mmmm.mm��mx.'mrnummrcw��rn$_un�--raiA"�._Y9'.1....0�✓�S:uui,�`^""J'„r L ^- -^-s -r- _.,. ruu wax v� �mmm _._ -. � wm.uu.,wrmmm .rra.,✓o-w� ,w,ry e.r .,, err:.��9..".r��,a✓.._. ...�.�wkrn-uuew.e_ ,, �. n.r,rr.rd',4m -m,..,....:....n.,✓.«..,_ .,np��+r, .�x:.,aar..,..-rTuun.>_r�.,ur _ _r:,-rw�Py�✓' �mn....r..werm "xw,rr.a.,ewa� JJI I, .✓n_...:.e aYlp� rylly, Ippf, fP N�., ......_........, m. -.._,N--",.,m.a...m mrn,n.., �n..rn,vm.nm.�m�.rin,.:-,✓,,. ,..y wx„,,;,,,, n...an�.a.ew-, a,_. � 4.'-� ._ i..errnwrti:i.,wrw�.Yaen.rui.ua�w' •,^.,�"••-°'ro ,rm--r.-.e wxm✓wmms. ,.ne ,�..m_,��mm,�Txe_...a+�a_^ae,C'�-'r _a._�,__... �.��,�aw'�N.✓..,x:m.,.ronn,*.. u.✓,.�;,rs,m,m!✓`�T...d'P'l..e ,w.raa,a.a wxaC..A�wlaaa.S.�✓.._, INSURANCE COVERAGE 1 have a current 1i�v Insurance Iic or its substantial equivalent,which meets the requirements WLa Ch,142 YES N 0 ��a IF YOU CHECKED YES,PLEASE INDICATE'T 'E TYPE OFCOVERA E BY CHECKING E P �r I T I� � ' T � ' ' INS "IL.�I IILITY I S C POLIC10( T D BOND 0-j OWNER'S INSURANCE WAIVER I am aware that the licensee does not,have the insurance coverarequired by Chapter 142 of the assach usetts Gener l La Sr)and th at,my sig n atu re on,this permi licatio a waives this req u it ntd CHECK ONE ONLY E [:DJ AGENT [ l' SIGNATURE OF OWNE ENT M hereby certify that all f the details nd�information I have ubrnitted,or,entered regarding this application are tare and acGuratethe hest of my knowledge andthat all pl'umbIing work rid installations perfor r d under the permit Issued for this application will be in compliance ith 01 Ise irient pro sr the '1 hus tts State Plumbing Code and C ter 11 f the G ' �r1 LIHI 01011, LUMBER GASFITTE I F � mm..d ' LICENSE SIGNATORE I H ID GF[JI � �� � LI�GILCORPORATION rj � T I N � II ,� � LLB � I 'uddibM@kti'f wa-mow ror a.. !"� iYyH ... IIWIYIBWHv¢i¢FHrmi-- Y,HWeia�a�' M`•� + wy'- Y'1'.HtiH,IDYiu, J^ ATImHGtlV I¢.M�vw p"¢ HrnYYHnYPuti'H' Ytl�.". .�Alw�, rn¢1nf¢,�A,HMA„ertaM.9ry wMwrv.v�.H.A�." 'yyyylV,1„H'Ara'�' "' � a .. . COMPANY NAME: � ESS .Ya;. _� �.n�g .am � r�. �.,�g,✓ � w �r ,¢xn.. pa� ----a. em. g.g�x„�.rx.��.mm✓r�a n Hg„rvH.Hg.Y,� �a ,i CT �TT� I w II_ -- x.., rv.�r�H � rrvaw�YY.Y�uYi�YraYai� � _ .. .w.aw.a 7H✓�.Y��JtlYi,aA.ir�YY,aa2a � r -177 FAK CELL 'MAIL � va¢w., "C¢��.uy'.r�iw.rwg�nv»a• �¢I,tw<ilww,�,swwu.,�.aw .�m�.e, ..amm wa..m.a_a ,� �.-. ',.�"!':"�:..,�°�^.w.._... �r.e�.,✓ ,�.b,�'u'_ � I 5 UGH GAS,INSPECTION„NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPIECTION NOTE,S THIS APPLICATION SERVES AS TW PERMIT ❑ FEE: PERMIT z2 A CLAN REVIEW NOTES v LAI' kvT- or >r ; .......... !9,.. M. B ,:' ::: .,. . =:; :_. -" :€ -;;;• ; 26, : IA M _ N H 0 LIM .s r i I; �o i 1 i i l i / / f i a J+ ' f � w'+�w ww. A"IM w�w.4 ere w w.w J/ P,lie f OT TOWN OF NORTH ANDOVER imal Top P� Hu ,f * certifies l 19 .wwpww�' ue.eww..•................ x'�Yeu w, e....... ........... has ( ion w uw uw w �...... s. YS ..uw.ew w.pww.uww.�w euw ��� . w to e pub .orm ....wwe......w/ / r PI mb a w . p in the buildi ings I ......... .. w ww.�.....w. .w.w�. North Andover, , Fee ....w..ww�w No,. / • w w iy e MHq. IAWy.....e.. w.ew IY y��,p Check# rrr„� %�r,� LwINGweI. Sy�`11�eAY e.11 rXf J IY w //�/ / •w w w wuw to j j I I 11/ �f I J�( I J I 1 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORIVI' PLU M BING WORK I Al I �'�n; � �4 '' M DATA ��' :. PERMIT it JOB rx��swµrr�ww�wxwwxsrswew9ww �. .. � OWNER'S� i Le, SITE ESS ✓ S NAME owilIFAX II CEO TESL0 I m �� .. � .��, _ � , �.�.✓ TYPE OCCUPANCY TYPE COMMERCIAL EDUCATIONAL, ��' �aESI RESIDENTIAL PRINT CLEARLY NEW: RE TI 1': REPLACEMENT: PANS SUBMITTED-, YES �' NO FIXTURES� S 1 2 3 1 , 11 1 BATHTUB r CROSS CONNECTION DEDICATED SPECIAL,WASTE SYSTEM Ipp � 7ppy IIr .�,,.� a,*^^�,n'm4n. -,,;�,� �..,W_� 4N""1 Rimw��M ...,....,,.'�.++�,umm..,m.l �w���y,✓w..*x,,. �.,,�..��..,�,..,;..w,w wm,nnrmwr..+m�w wMnw:N. m..wMm��..f,r+'�-a,.-.�mx.. �,�:+i.,rv,.M..w,,.vMd4 I- ��k �''� DEDICATED G S IL_/SAND SYSTEM All DEDICATEDGREASE,SYSTEM _ DEDICATED GRAB T SYSTEM DEDICATED WATER RECYCLE SYSTEM DRINKING FOUNTAIN' DISHWASHER a E DISPOSER �_ �K ��. I 1 . V I FLOOR/,AREA I � I f INTERCEPTOR �_ . _�. ..� �ry....� ,,,,(INTERIOR) 11--l-I-j KITCHEN SINK DTI �rr ROOF AIII ry r 1 SHOWER STALL p w 8 i �.� m � s 57 � � Y SERVICE SINSTOILET AFEW I _ 3 N 'rl I p �kAb.IIINAG MACHINE CONNECTION a II a m. TER HEATER ALL TYPES i P.,� ✓arm �. ,,,, — �m,., d WATER PAIRING e L"I-L. OTHER n, .�.,_ I S ..... �n, I n; n::,'i w +.,,, 'r-~�'..._+nmx.,xenwn mme<Wn r-,.�,"-�Pu�w�:.vrw'n✓uur � ,�. �' '� -n-�mm,uT,nmm'+,niune,uniwrw wtr:urmi A II11 W Y nr,m u._r,k,v.a.•a .. ^. M 6 -, __...-_RC"_..,.,_.1, '..�!T"" W m.Y::Mn 1b.n.. w'..P� r ,r t. �.,ne a P'u�'✓m. 1b,MM w+TA.-see ..�r.n-,:Msuunx � r. m,.,.m xmr...u. _e�u� rva n,.,an,m, .. nau,- ,m-�,T,-+mv-.�e:.mmuun:rcw nv;mmmnzwwmm�e T_. .•••• -��-. �„ �. 't � ._��_, .,.,_� � �w,.w, •u,u u,.c 4uq m,MxiM. I ,-,�e-roe.-�mnryn-mmvmmmm xmmmuunxx u,emtw miuv.�:rm r ,n .. �'.. _ r .. •A'WAW'� MM19'iwMwM'f�oi MMM�d.M'WWM'7,�9 INSURANCE, current liability insurance II r Its substantial equivalent which meets requirement'sF/ IF YOU CHECK E , I INDICATE T ' T COVERAGE CHECKING APPROPRIATE X EL LIABILITY'INSURANCE l_.I ' P " .�w TI�EITI �EI�II�IEMP°�IIT ` .,..�.�� OWNER'S INSURANCE I aware that a licensee does not have t insurance coveragerequired MassachusettsGeneral Laws, that, antra is permit I tI waives is requirement'. I , CHECKE SIGNAT' RE OWNER GEIIT M r b� rfif that all o the e ll and information V have submitted or entered regarding th,i hp��dy ,l n .re true and accurate the best my knowledge and that allplumbingw r n 'Installationser rmed under the r �issued � , r application will t compliance,w l rtinen S of the Massachusetts State Plumbing Code and Chapter 1 o thy,General Laws.717 �;;lA/ �a PLUMBER NA E E -4 E SIGNATURE { MID ip >, CORPORATION 0#, 'ATI' ISI-III'E�:_w� II�C �_..� � ,. COMPANY NAME ADDRESS s � , �' w�� � le k CITY' �TTE I I ' go") TELA FAX 'CELL a "I, AIL o , M I TEs BELOW FOR r)FFICE USE ONLY T � Yes o AT[ SERVES AS THE PIERMIT FEE. PERMIT . REV N ..............:�.:. <z".-------xs.x r-:_.#.. #.:.::::.:_.,..•.:v'::�r r r,'=r_',r z=*�==-•�s.• �s~v r'< z � ,.. __k..k � k: �_ �'z_a\^~v3��}:.....~v"v:��k•''f�k {<z'. ��,:'. '.',�:t .,�. k..{.n:.,�,,.�. #4 • i ite Commonwealth ofMassaOusefft , ern t ofln dos frAW ts Office of Inves9gations 66 " Washington Street Roston,MA2 www.mass.govIdia workers, Co n n . .�. � vR: �c� o -r . t �rr� /E i ns/Pl P A-p-oficant a . . Please Prat Le � 'Name,(Buznosslxgaationftiu .: Address: Phone 4.__46 cityAstatolzil) Are you an employer?Check the RpprOprlate box: Type of project(required): 1.Ell a eniployer with , E] I am a goncralcontractor and he the sub-contractors(MancyoxPat-tiWO., ffig �C)ipl • to o the attached ad.�F � o e 2. 1 am a solo prop-rietor or P artner-- ship .� . ��.�. �� ens These �. --cnorElDemolitim workinglux .e ia any Capacity. workers' comp' ance. 1 0 IBO&gaddition [No or�---:r ' C()MV.,hJSUraU0G S. we area corporat an and its Electrical � .�r ..� cep hav e �oi .. e0 � , additions additions 3 1 1 am a hoincomer fting a s right o e . on r MOL x M, �.[NO WPADY COMP, a. e R � i �= employe or .� ' m x . 13.0 mer comp. or rwrc .] *Any applicant that dLooks box t must also M mit tho section bi-,16w showingthek r rs'corq nsafloa p011G informatioa. Homeowners-rho submit ihis affidavit dicat' fro �io dping all word'a-ad then hiro outside contradors must submit a m w affidavit dica g Bch. TConlractors mat checkers box m-mst attached gai9dditiomd sheet show' e namo o .e sub--contractors are them` oz er'comp.policy Monratio . r- rt r m ait emloyer that o, e # mein e or rgy mo, . .p fi o cw ', o f site Nmlo - o R CY#or 8 alf-in .f1c.ff Expiration Date: Job Site Address-, i y tote. i * Affach a copy of 4e workers'compeMation-polley declaration page(sfaowing the policy number and explxatloA date); Failure to s ecuracoverage,as 3roqa u6d-undex S e otlon:25A ofMGL o.152 cap lead to the imp o x o-a of orhninal p onalffes �e,-ap to 1,5 0 0.0 D a-n o� R0-Year 1 o ant,a weJ1 as c 1vil p enaffle s in tha ffobof a STOP{WORK ORDER and a fmc o t .o a. a st eta I.ter. dvi c `ha oo r offs Late ent . "�a c c , thec-of, bvesdgaflow oche DIA for mhisurancG coverage-verification. { o hereby y eer ,� c e ` e i renat e o, ' rthat tho information pro c s above is fra andearred. 7/�Date: W moo. Phone 4. Ojfrelaluseo,41y, Do not vrite ht&IN area,to be completed by city or town official. City or Tow= Permit/License 0 TssTiing Authority(circle one): 1.Board of MaIth 2.Building D epartmeRat. 3.CtdToym Clerk 4.Electrical Imp ector5.Plumbing Inspector *Other CoMact Verson: Phone Mo � - l r I Date 'TOWN OF NO 01 PERMIT FOR WIRING at i p T� This certifies that � ..�em,e...,...........e.....,..................................... ..............� has on to pe,--f6rni perryiissi s�,...... I.."................... ........... f ............................... at wiring in the buildring ......... .... ......&..w..�.m......w..s...... rth.Andover, McIll 2T), '�C'e Fie ��� J .....���o.�:�.,..H..�..�.., ...�, w,,.. t i(CAL INSPECTOR, r, � b s. y offic,111al Use Only Commonwealth of Massachusetts 1) Pe nni t No.. Department ofFire Services loop BOARD OF'FIRE PREVENTION REGULAT�IONS Occupancy and Fee Checked, r TIONFOR PERMIT TO PERFORM ELECTRICAL WORK Ali workto be performed in accordance with,the Massachusetts Electrical Code C),5'( R,12.00, (PL EA SE A ",y r InspectorTjo, C)"tty or Town of: 'NORTH ANDOVER To the y thisapplication: the n e:�i :givesi ,�f r �intention r the electrical work descri bed below'. Ilion trey erg w Owner r Tenant Telephone No. Owner's `7 Address4 2 s i � wit o permit? (CheckAppropriate x 0 11 ,Purpose of Bul"IdingUt'fity Autho, 1� 1 Existing Service Amps Volts Overhead Undgrd New Servi'c le ,:j,? Amps, 1( 1,ty 1!L,4'i Volts Overhead Undgrid No.of Meters Number of Feedersand Amplacity NatureLocation and Electrical Work-. .................. c, 1�,,ivs,L'� rr gompletion qfthefiollowin'g table m� e the Inspector f Wires. . Total No of ss _ . . ,i . -Sus . Fans ass Transformers KvA ,No,. of Lurnionaireousts No. of Holt Tubs Generators Above 0. i ,tic k n g ng Po.01 grild. . - � i IJ 1n r . E] its r iNo. of Receptacle data Burners F Zones RangesNo. of Detectil.'on nnd Total No.,of A1*r Tons . ofAlerting Devices, Heat Pump .of elf- l" Municipal Heating lEln �No. of Dryers HeatinIg Appliances • .of Devicesr Equivalent No., tee Nol.of No.of Data Wiring:KW w . Heaters r omrr Signs Ballasts No.,of Devicesnt �Telecommunka,tions N .Hydromassagre Bathtubs N .of'Motors Total RP N .of Di ces or Eguivalent Attach additional detail ifdesired, or as reqzdred by,the.inspector of Wires. Estim.at,ed Value of Electrical,Work: en require:by muniiicipal policy.), o Work ,Start: ` ) e l �s requested accordance with MEC Rule 10,and upon completion.2 hless waivedby the,owner,no permit for the perfortnance of electrical workmay issue unless the licensee provides proof of liab* undersigned, 1filei that such cover I ' M force,and has exhibited proof same the i � Deice. C CK : INS I :SCE IBONDEI T Sccfyl _IcerfifjO, rinderfliefains andpenalties ofperj`ury� information application is true and complete. FIRM NAME111 LIC.NO. r m Lic '£ 1.M WW`+b'o rr nature[ I"'waWa^ Y4A M.imw® M1 � m r . rater '" in � z the license number line) . . ¢: �� � r " i r, � ° . Lyo`A—w%6 Vi,i-bL2,, .,,,AokA 0 i E774L, li_ Alt lb, . equires OWNER'SINSURANCEWAITER-6 I am mare that the Licensee does not have the,debility insurance er , ally required bylaw. y ry si nature clown, hereby,waive this requirement. the(chei ones owner is agent. Own,er/AgentPERMIT " c, rd v' tie provision' ,nie s of , . ,. } the . acuefts riel ide ce .: permit applicat1en far�-n to. -o ide rlotice of in talxati ri of wiring shall be uniform throughout the Commonwealth,and applications skull b filed on the Prescribed form.After a permit application has been acecpted by an Inspector of Wires appointed pursuant 1 I. x.l� . 1 ,an electrical permit shall be issued to the person, fine or corporation stated on the permit application. Such entity shal[be responsible for the ' 3�k notification of completion of the work.as required in MG. .c.143, Permits shall.be limited as to the time,of ongoing construction.activity,and may be deemed by the hn peetor of ires abandoned and invalid if he or she has detennined that the authorized work has not commenced or has not progressed during the preceding 12-month period.-Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. The Permit Ex ten sion Act was created by Section 173 of Cho tee'240 of the Acts of 2 0 10 and extended by Sections 74 and 7 5 of Chapter 23 8 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension.Act furthers this purpose ose by establishing an automatic four-gear extension to certain permits and licenses concealing the use or development of areal property.With limited exceptions,the Act automatically extents,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect`ect or existence'during the qualifying period beginning oa August 15,2008 and extend i ng'through August 15,2012. El ul �-Permit/Dat Closed: Note:reapply for new permit ❑ Permit Extension Act—Permit/Date Closed; Trench InsPection W Failed Re-Inspection Required{ I Passk ins tors Comments�, fi .......... .......... Inspectors Signature: Date: SERVICE CIS: Pass Failed Re-Inspection Required El Inspector oMments: zt ate'�YL + Date: Inspectors Signature: �...s-. � PARTIAL ROUGH INSPECTION: Pass M Failed Fie-Inspection Required . InspectorsComments: Inspectors i nature: : t UGH INSPECTION: Failed ate-Inspection Required Pass lnpec'oCo ent : Inspectors Sig nfire: Date: FENAL ASP Pass❑ Failed -Inspection Required{ .�El Inspectors Comm s: N .}: Z. Inspectors Signature: Dat L/ Al DEB WEINHOLD ... TOWN of MERRIM MA. ... ...dweinhold@towno€ errimac- or t -- .die Commonwealth o,fMassachusetts .. i- Department o,f ndastr c AccW ts i Office ofInvestigations 600 Washington Street Boston,M. 0211 www.mass.gov1dia F Wor ear l Compensation Insurance Affidavit: Builders/Contractors[Electrj*ciansfPlumbers icant Information Please Print Legibl Name (Business/Organizationffnd'iv'ldual) Address: - y f City/State,/Zip: A4egk Phone : Are yo i employer?Cheek the appropriate box.- Type of pr j cet(required): employer , [11 general contractor and 1 � le . _. . fqUwconstruction employees(ffll and/or part-time).* have re d. s �e n rae o s 2. I am a sl proprietor or partner- listed on the attached sheet.3 • E] .em.od hng ship and'h ve no employees These n -contractors have 8. El Demolition worms for me inany capacity. wo 9. 0 x er ' comp,ins ran e. Building addition [No workers' ce�ar�, .insurance We are a corporation and it officers have exercised their �. .El�leElectrical xcpas or additions required.] o� .El I am a homeowner doing all work right of exemption per M IS 11.0 Plumbing repairs or additions myself. [No workers' comp, c. 152, §1(4),and we have no 12.0 Roof repairs insurance requirefl t employees. [No workers' 1 their comp,insurance required.] *.Amyapplicant that checks box 4 1 must also fill out the s ecflon below showing their workers'comp onsa on policy infonnation. t Hom own rs who submit this affidavit indicating they aic doing all work and there hire outside contractors.must submit a now affidavit indicating such. t ontra for that check this box must attached additional sheet showing the name of the sub-contractors and their workers'comp.policy inforrnation. -am an ernpl yer that ispro viding workers c ompen s a ion in s u ran c e for my employees. Below is th e p o 11c n djoh s U information. Insurance Company Name:_ A, � Policy 4 or el- .s.Lic. : Expiration Date: Job SiteAddress:- : 0 �� � city/state/zip: , r � Attach a copy of the workers'compensation o cy ileclaration page(showing the policy number and expiration date). Failure to secure coverage as required.0 d r SoGtion 25A of MGL c, 152 can lead to the imposition of crl'=* al penalties of a fine up to$1,500.00 and/or on.c-year imprisonment,as well as civil penalties the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a.copy off statement maybe,forwarded to the Office o Investigations of the ICI.for insurance,coverage verification. coo aereby erto nder thepains andpenalties ofperjury that the information provided eve is true and correet Signature: Date: Phone : 7,S :QL-t7-7_,- Official use only, Do not write in thisarea,to he completed by city or town official. City or Town: Permit/License hsulng Authority circle n -: �. { 1.Board of Realty 2.Buildfng Dep r iftwnt 3.Cityffown Clerk 4.Electrical Inspector 5.Plumbing Inspector .other Contact Person: Phone 77 } 4L 7 TT:..::v:.....,::,v:..::::::::..,,;..,..:..... ON SOA : , ._. .== x RN'E:-.Y-.:M k. :;.. tTR J.0 I A N LU f. . �. .... ............................ ;....::....v0-:4........... �. w.... ...;:.. k .' ... ...... . .: ..; . i� Loc,atio I Date TOwN OF NORTH ANDOVER i r Certifibate Of Occupancy - inq Pevnit Permit Fee Other n-i TOTAL, Ghea Al y /r f ti i Building i / l z Location „v F r t / f � iouuu rOWN OF NORTH ANDOVER / Certificate occupancy . Fee Buildinig/Framl"� 'it Foundation t Other Permit e k Check Building inspector 1f/ f bAORTH IL BUILDING PERMIT 0' �E,0 0 TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION oe Pe rm 1ft N oM Date Received 'rIEV CAU Date lssued�, IMPORTANT.: Applicant must co�mplete all items on this page .... ... "n" Kill ............. ME VE ME A I'd M P 5 / ON '8140 �,YYIM MaNI P I%,I�L AJ W/M aw e W, !vIe "A no,, "."PP TYPE, OF' IMPROVEMENT --PROPOSED USE, Residential' Non- Residential ...........- kr, New Building K'One family F1 Addition [I Two or more family El Industrial El Alteration N o. of un its: El Commercial ... ......................... Ej Re�pair, replacement 0 Assess,ory Bldg 0 Others: El Demolition E] Other 0 et ethd8 a ers e I�tt ifc,/,,� 'El-Well , 10, Rob pain,�`/ -11'vv'�, k-" "' t hi"I"d01 a r/Sew DESCRIPTIONOF WORK TO BE PERFORMEM &44rk lag, Identification- Please Type or PrInt Clearly' ,OWNER- Name- T IL2 L L(.e Phone- Add ress: 77- C,=>w' N) '77 YY 7-, 0 ne" �Me 7/ J, -g�/I'/"////,/ 4' j., At "AM/ r 51 ........... ........... N,i",7,11 '�P V1 af t w/'j iio/// D" r E'/ //p ..I....... MW� 7 7, "M 7/7 tYWOM/a Lk 0/l/ "'21 .... ........ a� 20 P/," 4 ARCHITECT/ENGINEER Phone: Addressi- Reg., No. FEE SCHEDULE."BULDING PERMIT:$12.00 PER$1000P 00 OF THETOrAL ESTIMA TED COS T BA SED ON$1,25.00 PER S.F. 'n '44 Total Project Cost- —4-,1) FEE: 4u, Check No,.' Recelpt No., t2A NOTE, Persons contracting with unregistered co actors do not have access to,the guarantyfq 000 0�0 ,,Signature of.Agent/Owner Signature of contractor 4,500 0 Towil Uf dover ,,tom �, 0 . Al- +` 1 . 0 N -. - 4 h. vex Masi %j 1324 e Co LAKE NICHtWMIK An 01 Ll BOARD OF HEALTH Food/Kitchen Septic System Ail BUILDING THIS CERTIFIES THAT .......a#..... .a.■■■at.Y Y■A Y.r r irrr r ..,a,aaLaa,a=a........ya Xarr.Y,.y„il.■■11■ FLLL„iFL■11■,a,,..■ss..r.a■ IN } E T OR`` Foundation haspermission 6 ■■■:■■■■■aaaL■■aaas■■■■s6,, �dl ■■a ■■ as ■■aaa■■■■a.■ a.s ■�■ aa■■.■aa.■■■a.5Y raa.■■■r#■■■a■.■Y■aso oug to be occupied .....asa■ r ■■■■a �ia■■ ■a, ■■ass..■s■■ ax■■■■.x■■ aY■ ■ a ..■■r.a■■■Lisrrrra:r■.■aas■r■.a:.■■■ii.■■aa■■■■s■a 1 imne JTprovided that the person p this shall in everyrespect conform to the terms of the application on file III this office, and to the provisions of the Codes andBy-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPE VIOLATION hZoning r Building Regulations Voids this Permit. Rough �... � Final f PERMIT EXPIRES IN 6 MONTHS E.LE TII AL INSPECTOR 1<" L( UNLESS CONSTRUCTION STARTS Dgh ILI Service - L■■■■■a It■■■■a#■■■ Y a s■ ■■ #.■ l i J■ ■ a f i■■■■#i■■Y a f■■■!i i.Y■■i#■■■a i■■■■a f■■■!■ ��� � BUILDING INSPECTOR 14 CAS INSPECTPR OccMancE Permit Required to Occupr h Final Display1 a Conspicuous Placeon. the Premises _ Not Remove . .. .................. No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspectorl Burner Street No. Smoke Det. �o i Tow of Andover •ff • + f No . h ver Mass L A K 0 ' Coc«4IC10VVICKU. ` BOARD OF HEALTH Food/Kitchen Septic System THIS CEF TIFIES THAT .....r T..#s..... .....ia..rM.9 ....LL. 031 As Mrrrx*i4RR31}i,„7a■■,■rs■■,■z;Miyiflli,ggW1: i..aiFRNNMorFRR11■zP;4PR4rsr■r BUILDING INSPECTOR has 6I.a lK,��EF ■A��IE to erect lb Foundation permission 1� 1.tV s�r..aas.MrMFr}s....aas..6,, I�dings onss■ ■a ■■ .....atr...■ r.■ .r�iar....i.rrrri.rrrx sr.rr:..■■as....is..■ - to a occupied aChimney ��. ..R}....i ..■ a[}..■ ■.ai.■ .ii .as..... ■.....r..a rrr a r ■y*srrrrxfarrrxarrrr**sryyr#syyyyxMyyyX�KyNrrxKrryprovided that the person accep thistsh l in every respect conform to the terms of the application a on file in this office, and to the provisions of the Codes and By-Laws relating the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSIDE OR Rough VIOLATION of the Zoning or Building regulations Voids this Permit. Ir .2 )1.11�) )9 Final d�L On PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTSDgh r V Service ■■..i#....i IF F...IF i... .i ■.■ f..■ i ......}al...i it!.....3....i it i..■■i.....i..i■ BUILDING INSPECTOR � GAS INRECTQ Occupanc]EPermit RgAuired to OccupE' Rough in a Cons icuous Place on. the Premises - o Not Remove FiDnaisplayl No Lathing or Dry Wall To Be Done FIRE DEPARTMENT TMENT Until Inspected and Approved by the Building Inspector. Burner C"tStreet No, Smoke Det. 12 r oL A E OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Pe n it Number 030-1 1 2 _ Date: December 15, 2014 THIS CERTIFIES THAT THE BUILDING LOCATED ON 700 Osgood Street MAY BE OCCUPIED AS a singly family home IN ACCORDANCE WITH THE PROVISIONS of THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: TKZ, LLC 78 Great Pond Road North Andover, MA 014 Building Inspector Fee: $100.00 Receipt: 28358 Check :Cash a O SPL eyc'aa:ta w• Top CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number o -1 on ' 1.o 01 Date: December 15, 201 THIS CERTIFIES THAT THE BUILDING LOCATED ON 700 Osgood Street MAY BE OCCUPIED AS _ a single family home IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued o; TKZ,L C 78 Great Pond Road North Andover,MA 05 <r Building Inspector Fee: $100.00 Receipt: 28358 Cheek :C hi l e , APPLICATION FOR CERTIFICATE OFOCCUPANCY/INSPECTION B'UMDINGPERMIT c"us c-4 6/ ADDRESS/LOCATION OF PROPERTY:. c)[ Map-- sLot Number, SUBDIVISION- DATE REQUESTEDFILED/READYFOR INSPECTION, CLOSING.DATE ONPROPERTY: Fly�E5) DAYS NOTICE ALL WORK AND, SIGN-OFFS, MUST BE COMPLETED W� IS TIME �.�.,. .E. A mm.w Z__ REINSPECTION FE E OF TWENTY DOLLARS ($20.00),,,)'��f L CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CO ES. APPLICANT SIGNATURE 'I(ae w^ �s Per Issued to, '71 A�,e' i Address: AA .... y. IW �f L ROUTING 6 LA. a TOWN ENGINEER SITE PL D VE-WAY RE VIEW ..f f CONSERVATION PLANNING o. DPW-WATERMETER SEWE CONNECTION DPW MUST INDICATE THAT THE WATER METER,HAS BEEN INSTALLED PRI,OR TO SUBMITTAL OF THE 0CCUPANCY/INSPECTION REQUEST DPW SIGNATURE mx I N p(u"y File,Application for 10C forrinrevised Jan 2 2 1 I Y 1 f ro TA? MAP 100 PARCEL 11 .0+ 109.7' hi LOT AREA Q j + 46 V ff L I r 4.tilr 39.35.8' 4.O' EX. CONCRETE .0' FOUNDAMN C�b #700 . . ' a- - 0 16.0 22.0- 22.0 76.2' 0 .Or 0 0,0 0 ' k 4x r � 1. L 15.60 . ZONING DISMI `T, R, MIN. LOT AREA.- 43,560 S.F OSGOOD sl T MIN. LOT FRONTAGE: 150 FEET FAIN. BUILDING SETBACKS: FR N T.- .30 FEET SIDE. JO FEET REAR. 3 FEET I CERTIFY THAT THE FOUNDATION SHOWN WAS OUNDA ;70N ASo—BUIL T LOCATED BY AN INSTRUMENT SURVEY AND THE I OCATION COMPIIFS WITH THE ZONING SETBACK #700 OSGOOD STREET ZONING DISTRICT. NORTH ANDVEF , MASS. tom ' PREPARED Y: v J H N D. SULLIVAN 111 P.E.rv; a rD �. 22 MOUNT VERNON ROAD C�� t `$. v No MA 01921 41&W (978) -7871 � " ' SCALE: GATE: 6/11/14 ii,doverilly T o 1i,,xkTn ,.�r,� k0— No. LAKE h i r 4 ver Mass, 0 ic#CH1C14t WicA OftATER P` %U. BOARD OF HEALTH 7 Food/Kitchen 1 ir Septic System THIS CERTIFIES THAT ■skaik■■aiLEEEExsLE■azkrEErasrE■ rrrr L.Ca.........90003k h;MM%A LhNMM I LNEEMAZEMENAMMEMMIs ■■aas■■■iaE■■■aEe■■■aEENN* BUILDING INSPECTOR has Aspermission Q NiAY A erect rQ ■■■ra rrE■rsrrryWaaE■EE;REE E F . � Foundation L n t Rough to be occupied ■E E■■■■i i i ■E E i L 0 0 0 6.. a k E E■ E■■E ■E E E#E E E■i ■■E i ■ Ong i E E E E l#E E E 7 Z E E E E a I Z E E E E#E L E E E SEEMS i E■k 1R*F V FR P;1q Chimney provided that the person a tlis pt shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and Bar-Lags relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR i Rough VIOLATION ..,. ft a Zoning r Bu idin Regulations i s this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service .1AEEEyaa0EErrLr90/9arr . a ■E■a#LEEEa:■EEa#k■EEaa.E■■EiLE■■■i#L■■■■sa Final BUILDING INSPECTOR GAS INSPECTOR Occupana Permit Required to OccyMBuilding Rough Display i.n a Conspicuous Piave on. the Premises — Do Not Remove Final No Lathing Be Done I=� DEPARTMENT Unt-i-I Ins eved nd roved he iidi ins eve Burner Street No. Smoke het. :..ray!<• x..r ��'z}}.-, �1 sn '•rt:;ado':' ~ I _ } Thomasrxto ... 78 Great Pond Rad North Andover MA 1 410 512 01 a w c�\` ..I- h I O'Z.�"V I "I'v3,qNi i C-.)0-1�. 1*c%�lf.ls 0 iIQI 4.-1 '�.o I--t-jc--0l"l-.)D-,",,D i�i 11..1..Il..1�...�-I.�I..oc,....N..z'..-11- pp :.:::� ' l� .:.:.'... ...::.......::..........:.:.::��.. ���.....�...::.-...�.:..: .:..:::.:.%....%.::.:::....:..::-:.:.�..:......:-:.:... -.%:.-.-.::.%�:% ...::..... .%:�.. .:.-:...............:::. :...�.:::.....:.%%...:....% .....--.....-��.:.:.",;....,.....%�.�.-::.:,�...:....:...... .iI.s..-z.L 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